Share your information with Nadia Wiltshire-Bernard

Nadia Wiltshire-Bernard

Intele Travel

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Full name"/>&#13;
		<field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Middle name" name="middle-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Suffix" name="suffix" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Preferred name" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Address"/>&#13;
		<field type="text" label="Line 1" name="address-line-1" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/>&#13;
		<field type="text" label="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="State" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Zip" name="address-zip" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Country" name="address-country" subtype="text" className="form-control"/>&#13;
		<field required="true"  type="text" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Travel Details"/>&#13;
		<field type="textarea" label="Destination(s) of Interest:" name="destinations-of-interest" className="form-control"/>&#13;
		<field type="text" label="Travel Dates" name="travel-dates" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Are your dates flexible?" name="are-your-dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="Departure City/Airport:" name="departure-cityairport" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Number of Travelers" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Ages of Travelers ( please specify if children are included)" name="ages-of-travelers-please-specify-if-children-are-included" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="🏨 Accommodation &amp;amp; Preferences"/>&#13;
		<field type="select" label="Type of Trip:" name="type-of-trip" className="form-control">&#13;
			<option label="All-Inclusive Resort" value="allinclusive-resort" selected="selected">All-Inclusive Resort</option>&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="Tour Package" value="tour-package">Tour Package</option>&#13;
			<option label="Group- Trip" value="group-trip">Group- Trip</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="text" label="If other was selected, please specify" name="if-other-was-selected-please-specify" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Travel Preferences"/>&#13;
		<field type="radio-group" label="Seat preference" name="seat-preference">&#13;
			<option label="Window" value="window">Window</option>&#13;
			<option label="Aisle" value="aisle">Aisle</option>&#13;
			<option label="Opposite aisle" value="opposite aisle">Opposite aisle</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Bed preference" name="bed-preference">&#13;
			<option label="King" value="king">King</option>&#13;
			<option label="2 Double/Queen" value="2-double-queen">2 Double/Queen</option>&#13;
		</field>&#13;
		<field type="text" label="Meal preference" name="meal-preference" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Hotel preference" name="hotel-preference">&#13;
			<option label="Economy" value="value">Economy</option>&#13;
			<option label="Moderate" value="moderate">Moderate</option>&#13;
			<option label="Luxury" value="luxury">Luxury</option>&#13;
			<option label="Boutique" value="boutique">Boutique</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Vibe preferences" name="vibe-preference">&#13;
			<option label="Romantic" value="romantic">Romantic</option>&#13;
			<option label="Rest and relaxation" value="rest-and-relaxation">Rest and relaxation</option>&#13;
			<option label="Off the beaten path" value="off-the-beaten-path">Off the beaten path</option>&#13;
			<option label="Party" value="party">Party</option>&#13;
			<option label="Local culture" value="local-culture">Local culture</option>&#13;
			<option label="Family friendly" value="family-friendly">Family friendly</option>&#13;
			<option label="Food and wine" value="food-wine">Food and wine</option>&#13;
			<option label="Multi-generational" value="multi-generational">Multi-generational</option>&#13;
			<option label="Adventure" value="adventure">Adventure</option>&#13;
			<option label="LGBT" value="lgbt">LGBT</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Activity preferences" name="activity-preferences">&#13;
			<option label="Beach and water" value="beach-water">Beach and water</option>&#13;
			<option label="Gambling" value="gambling">Gambling</option>&#13;
			<option label="Food &amp; Wine Experiences" value="food-wine-experiences">Food &amp; Wine Experiences</option>&#13;
			<option label="Adventure (Hiking, Ziplining, Diving)" value="adventure-hiking-ziplining-diving">Adventure (Hiking, Ziplining, Diving)</option>&#13;
			<option label="Golf" value="golf">Golf</option>&#13;
			<option label="Nightlife" value="nightlife">Nightlife</option>&#13;
			<option label="Arts and theatre" value="art-theatre">Arts and theatre</option>&#13;
			<option label=" Relaxation (Spa, Beach, Poolside)" value="-relaxation-spa-beach-poolside"> Relaxation (Spa, Beach, Poolside)</option>&#13;
			<option label="Cultural (Museums, Historical Tours)" value="cultural-museums-historical-tours">Cultural (Museums, Historical Tours)</option>&#13;
			<option label="Faith-Based &amp; Spiritual Growth" value="faithbased-spiritual-growth">Faith-Based &amp; Spiritual Growth</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Cruise Cabin Preference (if applicable)" name="cruise-cabin-preference-if-applicable">&#13;
			<option label="Interior" value="interior">Interior</option>&#13;
			<option label="Ocean-View" value="oceanview">Ocean-View</option>&#13;
			<option label="Balcony" value="balcony">Balcony</option>&#13;
			<option label="Suite" value="suite">Suite</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Budget &amp;amp; Special Requests"/>&#13;
		<field type="text" required="true" label="Estimated Budget (per person):" name="estimated-budget-per-person" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Any Special Occasions? (Birthday, Honeymoon, Anniversary, etc.)" name="any-special-occasions-birthday-honeymoon-anniversary-etc" className="form-control"/>&#13;
		<field type="textarea" label="Other Requests or Special Needs:" name="other-requests-or-special-needs" className="form-control"/>&#13;
		<field type="textarea" label="Any Dietary or Medical Restrictions?" name="any-dietary-or-medical-restrictions" className="form-control"/>&#13;
		<field type="textarea" label="Anything else you’d like us to know?" name="anything-else-youd-like-us-to-know" className="form-control"/>&#13;
		<field type="clientLoyaltyPrograms" label="Loyalty Programs" name="loyalty-program" loyalty-program-note="*** This field allows your client to enter multiple loyalty program numbers (you only need one of these per form template) ***" className="form-control"/>&#13;
		<field type="radio-group" label="How did you hear about Natty Travel?" name="how-did-you-hear-about-natty-travel" other="true">&#13;
			<option label="Referral " value="referral-">Referral </option>&#13;
			<option label="Social Media" value="social-media">Social Media</option>&#13;
			<option label="Website" value="website">Website</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>